Intubation & Ventilation Scenario 4

Solution

This patient is acutely hypoxemic. He is not adequately clearing carbon dioxide, which should be much lower in view of the degree of hypoxemia. This suggests that there is a shunt present. The major concern here is that the patient has had an acute pneumothorax and there is a loss of hypoxic pulmonary vasoconstriction. He requires urgent placement of a chest tube. Intubation is not necessary at this stage. Pneumothoraces are relatively common in young asthmatics.